A Single-Centre Retrospective Study on the Impact of Reducing Surgical Prophylaxis from 48 Hours to 24 Hours in Cardiothoracic Surgery

Introduction: In November 2016, surgical antibiotic prophylaxis (SAP) guidelines for cardiothoracic surgeries at the authors’ centre were updated. SAP was reduced from 48 to 24 hours, and dual cover with vancomycin cefazolin instead of monotherapy recommended patients colonised methicillin-resistant Staphylococcus aureus. This study conducted review compliance updated guidelines, compare incidence site infections (SSI). Methods: A list undergoing sternotomy in National Heart Centre, Singapore, March 2016 February 2019 extracted hospital’s electronic database; every fourth patient included analysis. The divided into three groups: Group 1 (before guideline revision, March–October 2016), 2 (post-guideline implementation, July 2017–May 2018), 3 (July 2018–February 2019). Compliance incidence, epidemiology SSIs within 90 days surgery evaluated. Results: 509 (Group 1: 149; 2: 184; 3: 176) included. There appropriate selection timely administration across all groups. Post-guideline proportion on >24 hours decreased 149 (100%) 55 (29.9%), 67 (38.1%) 3, respectively (p <0.001). Despite reduction duration, SSI rates remained stable: 4.7%, 3.3%, 5.1% 1, 2, (p=0.662). Conclusion: Guideline implementation significantly duration surgeries, no increase SSIs. Continual feedback ensure sustained may be necessary.